Allocating operating room resources to an acute care surgery service does not affect wait-times for elective cancer surgeries: a retrospective cohort study

被引：12

作者：

Anantha, Ram Venkatesh ^{[1
]}

Paskar, Dave ^{[1
]}

Vogt, Kelly ^{[2
]}

Crawford, Silvie ^{[3
]}

Parry, Neil ^{[1
,4
,5
]}

Leslie, Ken ^{[1
,6
]}

机构：

[1] Univ Western Ontario, Dept Surg, Schulich Sch Med & Dent, Div Gen Surg, London, ON N6A 3K7, Canada

[2] Univ So Calif, Med Ctr, Los Angeles, CA USA

[3] London Hlth Sci Ctr, London, ON, Canada

[4] London Hlth Sci Ctr, Trauma Program, London, ON, Canada

[5] Univ Western Ontario, Dept Med, Schulich Sch Med & Dent, Div Crit Care, London, ON, Canada

[6] Victoria Hosp, London Hlth Sci Ctr, London, ON N6A 5W9, Canada

来源：

WORLD JOURNAL OF EMERGENCY SURGERY | 2014年 / 9卷

关键词：

Acute care surgery; Cancer wait-times; Resource allocation; Health outcomes research; QUALITY-OF-LIFE; GENERAL-SURGERY; IMPACT; OUTCOMES; MANAGEMENT; MODEL; APPENDECTOMY;

D O I：

10.1186/1749-7922-9-21

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Introduction: Acute care surgical services provide timely comprehensive emergency general surgical care while optimizing the use of limited resources. At our institution, 50% of the daily dedicated operating room (OR) time allocated to the Acute Care Emergency Surgery Service (ACCESS) came from previous elective general surgery OR time. We assessed the impact of this change in resource allocation on wait-times for elective general surgery cancer cases. Methods: We retrospectively reviewed adult patients who underwent elective cancer surgeries in the pre-ACCESS (September 2009 to June 2010) and post-ACCESS (September 2010 to June 2011) eras. Wait-times, calculated as the time between booking and actual dates of surgery, were compared within assigned priority classifications. Categorical and continuous variables were compared using chi-square and Mann-Whitney U tests respectively. Results: A total of 732 cases (367 pre-ACCESS and 365 post-ACCESS) were identified, with no difference in median wait-times (25 versus 23 days) between the eras. However, significantly fewer cases exceeded wait-time targets in the post-ACCESS era (p <0.0001). There was a significant change (p = 0.027) in the composition of cancer cases, with fewer breast cancer operations (22% versus 28%), and more colorectal (41% versus 32%) and hepatobiliary cancer cases (5% versus 2%) in the post-ACCESS era. Conclusion: These results suggest that shifting OR resources towards emergency surgery does not affect the timeliness of surgical cancer care. This study may encourage more centres to adopt acute care surgical services alongside their elective or subspecialty practices.

引用

页数：7

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